这项临床研究对呼吸分析作为早期发现肺癌的非侵入性方法的实用性进行了全面研究。这项研究招募了14名肺癌患者,14个不同医疗条件的非肺癌对照,和3名结核病(TB)患者的生物标志物发现。匹配标准,包括年龄,性别,吸烟史,严格遵循合并症,以确保可靠的比较。采用了使用BIO-VOC采样器的系统呼吸采样协议,随后使用热解吸-气相色谱-质谱(TD-GC/MS)进行VOC分析。对所得的VOC曲线进行严格的统计分析,包括对潜在结构的正交投影-判别分析(OPLS-DA),Kruskal-Wallis测试,和接收机工作特性(ROC)分析。值得注意的是,13种VOC在肺癌患者和对照组之间表现出统计学上的显着差异。八种挥发性有机化合物(己醛,庚醛,octanal,苯甲醛,十一烷,苯乙醛,decanal,和苯甲酸)表现出实质性的判别力,曲线下面积(AUC)为0.85,灵敏度为82%,发现集中的特异性为76%。在独立队列中验证得出的AUC为0.78,灵敏度为78%,和64%的特异性。进一步的分析显示,肺癌患者呼吸中的醛水平升高可能归因于癌组织中过度激活的酒精脱氢酶(ADH)途径。应对方法上的挑战,这项研究采用了生理和病理混杂因素的匹配,受控室内空气样本,和标准化的呼吸采样技术。尽管有局限性,这项研究的发现强调了呼吸分析作为肺癌诊断工具的潜力,并表明其在鉴别肺结核和肺癌中的作用。然而,将这些研究结果转化为临床实践需要进一步的研究和验证.
This clinical
study presents a comprehensive investigation into the utility of breath analysis as a non-invasive method for the early detection of lung cancer. The
study enrolled 14 lung cancer patients, 14 non-lung cancer controls with diverse medical conditions, and 3 tuberculosis (TB) patients for biomarker discovery. Matching criteria including age, gender, smoking history, and comorbidities were strictly followed to ensure reliable comparisons. A systematic breath sampling protocol utilizing a BIO-VOC sampler was employed, followed by VOC analysis using Thermal Desorption-Gas Chromatography-Mass Spectrometry (TD-GC/MS). The resulting VOC profiles were subjected to stringent statistical analysis, including Orthogonal Projections to Latent Structures-Discriminant Analysis (OPLS-DA), Kruskal-Wallis test, and Receiver Operating Characteristic (ROC) analysis. Notably, 13 VOCs exhibited statistically significant differences between lung cancer patients and controls. The combination of eight VOCs (hexanal, heptanal, octanal, benzaldehyde, undecane, phenylacetaldehyde, decanal, and benzoic acid) demonstrated substantial discriminatory power with an area under the curve (AUC) of 0.85, a sensitivity of 82%, and a specificity of 76% in the discovery set. Validation in an independent cohort yielded an AUC of 0.78, a sensitivity of 78%, and a specificity of 64%. Further analysis revealed that elevated aldehyde levels in lung cancer patients\' breath could be attributed to overactivated Alcohol Dehydrogenase (ADH) pathways in cancerous tissues. Addressing methodological challenges, this
study employed a matching of physiological and pathological confounders, controlled room air samples, and standardized breath sampling techniques. Despite the limitations, this
study\'s findings emphasize the potential of breath analysis as a diagnostic tool for lung cancer and suggest its utility in differentiating tuberculosis from lung cancer. However, further research and validation are warranted for the translation of these findings into clinical practice.